Consumers with health insurance shouldered more of the expense for their medical care in 2014, but Florida and nearly every other state did little to require that prices for hospitals and doctors be made public — hindering comparison shopping and allowing dominant hospital systems and insurers to drive up costs overall, according to a report released Wednesday.

Florida was among 45 states that received a failing grade for neglecting to adopt laws that give patients the data they need to plan for their healthcare expenses, according to the report produced by two nonprofit groups, Catalyst for Payment Reform in California and the Health Care Incentives Improvement Institute in Connecticut.

By upholding the legality of insurance subsidies on the federal exchange, the Supreme Court secured President Obama’s legacy of expanding access to health care. Now Mr. Obama must secure the other fundamental legacy of the Affordable Care Act: controlling health-care costs.

Over the holiday weekend, The New York Times published a lengthy piece confirming and adding to what has been increasingly clear for months: All over the nation, health plans being offered through Obamacare’s exchanges are requesting sizable rate hikes. In particular, popular plans that had attracted large customer bases by offering relatively low rates seem to be pushing for big increases next year, based on filings so far.

Why is Obamacare still so unpopular? Why aren’t the working class and middle-class signing up for it? Why is the Obamacare population sicker and causing so many big rate increases a year earlier than expected? Is Obamacare financially sustainable in its present form? Is it politically sustainable as it is?

The long battle over ObamaCare’s subsidies that culminated at the Supreme Court last week has overshadowed a consequential shift in health insurance: toward high-deductible plans that will help put market forces back into medicine.

Premium growth in the Affordable Care Act’s Health Insurance Marketplaces has been an area of significant interest, as this is one of the most tangible and measurable indicators of whether the ACA is working to keep health insurance affordable. The ACA’s rate review provision requires premium increases over ten percent to be made public. As a number of individual market insurers are requesting 2016 increases well above 10 percent, concern has been raised over the affordability of premiums in the coming year. However, these increases are not necessarily representative of the range of products from which consumers will be able to choose, and similar data is not widely available for the plans with moderate increases or decreases.

State regulators typically use their power to review health insurance premiums to limit rate hikes. But in Oregon, officials are ordering insurers to raise premiums — in many cases by double digits.

The regulators pointed out that insurers spent over $100 million more than they took in last year. Any more money-losing years like that, and some carriers would surely go bankrupt.

Emergency room usage has spiked sharply in recent years. That’s the depressing finding from a new survey by the American College of Emergency Physicians – and it’s putting those who need emergency care at grave risk. The survey concluded that three in four emergency room doctors have experienced a surge of new patients since the Affordable Care Act became law.

That isn’t a coincidence.

The Supreme Court will soon decide King v. Burwell, the case that will determine whether tax credits being paid in at least 34 states without their own exchanges are legal. If the Supreme Court makes the administration follow the letter of the law, billions of dollars of federal tax credits will continue to flow to 16 states, but not the rest. This will result in a political crisis giving Congress and President Obama the opportunity to fix the worst aspects of Obamacare.

In early June, the federal government released data on the premium increases that health insurers in 45 states and the District of Columbia are requesting for 2016. The numbers were eye-popping, with many requests exceeding 20 percent and a few even exceeding 50 percent. They were definitely “death spiral” inducing premium hikes. Yet, some pundits on the Left dismissed them as no big deal.